Triamcinolone Acetonide–assisted Peeling of Retinal Internal Limiting Membrane for Macular Surgery

Does intravitreal triamcinolone acetonide-assisted peeling of the internal limiting membrane effect the outcome of macular hole surgery?

“…In vitrectomy, surgical separation of the posterior hyaloid from the optic nerve head or macular area can be clearly confirmed [12]. Recently, a new technique to peel the ILM using triamcinolone acetonide to facilitate visualization during macular surgery was described [3][4][5][6][7][8][9][10]. It is well known that triamcinolone acetonide tends to stick to the residual vitreous cortex on the ILM or to the ILM itself.…”

“…However, after intraoperative use of ICG for macular surgery, fluorescence of the optic disc and of the macular center persist for months [15]. It also tends to accumulate in the optic nerve and pigment epithelium, which may cause atrophic retinal pigment epithelial changes [3]. Recently, a new technique to peel the ILM using triamcinolone acetonide to facilitate visualization during macular surgery was described [3,10].…”

“…It also tends to accumulate in the optic nerve and pigment epithelium, which may cause atrophic retinal pigment epithelial changes [3]. Recently, a new technique to peel the ILM using triamcinolone acetonide to facilitate visualization during macular surgery was described [3,10]. The effect of triamcinolone acetonide assisted ILM peeling on the anatomical and functional result of macular hole surgery is controversial.…”

Use of triamcinolone during vitrectomy surgery to visualize membranes and vitreous

“…Injection of TA allows delineation of an ILM and ERM secondary to integration of the crystals into its superfi cial collagen fi brils (Figure 3) (Horio et al 2005). TA provides contrast between the highlighted ILM and ERM and those areas that have already been delaminated because the TA will not stain exposed retina (Shah et al 2004Fraser et al 2003;Kimura et al 2004;Tognetto et al 2005). If TA is utilized in the vitrectomy stage of the procedure, it can be reinjected for ILM or ERM visualization and the surgeon may require reinjection if the TA is washed away by irrigation or aspiration.…”

Triamcinolone-Assisted Removal of Internal Limiting Membrane Enhances the Effect of Vitrectomy for Diabetic Macular Edema

“…Indocyanine green (ICG) and TA have been used to make the ILM more visible during macular hole surgery [13][14][15] . However, there is evidence that ICG is toxic to the retina and retinal pigment epithelium [16][17][18][19][20] .…”